Boiled or filtered coffee? Effects of coffee and caffeine on cholesterol, fibrinogen and C-reactive protein.

Caffeine is the most widely consumed psychostimulant drug in the world that mostly is consumed in the form of coffee. Whether caffeine and/or coffee consumption contribute to the development of cardiovascular disease (CVD), the single leading cause of death in the US, is unclear.This article examines the effects of caffeine intake, both alone and via coffee consumption, on key blood markers of CVD risk: lipoproteins (cholesterol, triglycerides), fibrinogen (a biomarker of blood clotting) and C-reactive protein (CRP; a biomarker of inflammation). These blood markers and their role in the development of CVD are reviewed first. Studies examining caffeine and coffee effects on each of these blood markers are then presented. Next, biobehavioural moderators of the relationship between caffeine and/or coffee consumption and CVD are discussed, including genetics, sex and tobacco smoking. The literature indicates a strong relationship between boiled, unfiltered coffee consumption and elevated cholesterol levels; however, there is a critical gap in the literature regarding the effects of coffee or caffeine consumption on fibrinogen or CRP, which is an independent predictor of CVD risk. Available studies are limited by small samples sizes, inclusion of only men (or few women) and unrepresented age or ethnic groups. Thiere is a critical need for controlled laboratory and epidemiological studies that include fibrinogen and CRP markers of CVD risk before conclusions can be drawn regarding the health effects of caffeine and/or coffee in a normal, healthy population of men and women.